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Biomedical subjects

R J Todhunter

Publications and source records attributed to R J Todhunter.

At least 37 records · Page 2Linked to original sources

Effect of methylprednisolone and mechanical loading on canine articular cartilage in explant culture.

The objective of this study was to assess the effect of mechanical load on articular cartilage after in vitro corticosteroid exposure. Canine humeral cartilage was equilibrated for 4 days in defined medium with a serum substitute, then exposed to methylprednisolone sodium succinate for 20 h at 0, 0.01 or 1.0 mg/ml. After a drug-free recovery period, the explants were subjected to 0, 1 or 10 mega pascals (MPa) for 1 out every 5 s for 20 min, then incubated with [35S]-sulfate and [3H]-leucine for 4 h to measure proteoglycan and protein synthesis, respectively. When the loading occurred 22 h after drug exposure, proteoglycan synthesis was inhibited and protein synthesis, was unaffected by the drug. Both were stimulated by load, relative to controls. When the loading was delayed until 142 h after drug exposure, there was no biosynthetic response to load whether or not the explant had been exposed to the drug. Proteoglycan and protein synthesis 142 h after 0 or 0.01 mg/ml were unchanged or slightly higher than at 22 h, in explants which did not receive load. In contrast, biosynthesis were strongly inhibited 142 h after 1.0 mg/ml, and there was a 40% loss of proteoglycan content, relative to 22 h controls. If explants receiving 1.0 mg/ml also received heavy (10 MPa) loads 142 h later, there was a 17% reduction in total dry content suggesting severe matrix damage. These in vitro results suggest that articular load can help maintain normal cartilage metabolism after corticosteroid exposure, but also suggest that heavy loading after a sub-clinical dose can cause a marked loss of matrix solids.

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Immunohistochemical analysis of an equine model of synovitis-induced arthritis.

OBJECTIVES: To use lipopolysaccharide (LPS) to create synovitis in the midcarpal joint of ponies, and to assess the morphologic, histochemical, and immunohistochemical effects of synovitis on articular cartilage of the third carpal bone. ANIMALS: 2- to 3-year-old ponies, 6 control (group 1) and 6 treated (group 2). PROCEDURE: Synovitis was induced in 1 midcarpal joint of group-2 ponies by intra-articular injections of LPS (0.02 micrograms/kg of body weight), morphine (0.1 mg/kg), and saline solution (group 2a) and a morphine and saline solution alone in the contralateral midcarpal joint (group 2b). Articular cartilage sections and attached synovial membrane from the third carpal bones were examined by immunohistochemical distribution of interleukin 1 beta, tumor necrosis factor (TNF)-alpha, TNF receptors (P55, P75) and 3-B-3(-) epitopes, and by localization of proteoglycans (metachromatic staining). Proteoglycan extracts were assessed by metachromatic staining or western blotting and immunohistochemical staining, using anti-3-B- antibodies. RESULTS: Enhanced immunoreactivity for the cytokines and receptors was found in inflamed synovial membrane and noncalcified cartilage (group 2a more than 2b). Metachromasia of the noncalcified cartilage was greater in group-1 than in group-2a and group-2b specimens. In group 2a, chondrocyte hypertrophy and enhanced immunoreactivity for 3-B-3(-) epitope in areas of increased cytokine immunoreactivity suggested possible phenotypic change of the chondrocytes in response to synovitis. Immunohistochemical analysis by western blotting of proteoglycan extracts indicated strong 3-B-3(-) epitope immunolocalization in group-2a, weaker staining in group-2b, and barely detectable stain in group-1 specimens, which correlated with in situ immunolocalization. CONCLUSIONS: Intra-articular administration of LPS may be used to induce a synovial environment conductive to increased immunoreactivity of interleukin 1 beta, TNF-alpha, and its receptors in equine synovial membrane and articular cartilage. These cytokines may be involved in the early phenotypic change of chondrocytes that is believed to occur in osteoarthritis and is characterized in this study by enhanced 3-B-3(-) epitope immunoreactivity and chondrocyte hypertrophy.

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Effect of methylprednisolone acetate on proteoglycan and collagen metabolism of articular cartilage explants.

OBJECTIVE: The effect of different doses of methylprednisolone acetate (MPA) on proteoglycan and collagen metabolism of articular cartilage from normal equine joints was tested in vitro. METHODS: Cultured explants were treated with 0, 0.0004, 0.004, 0.04, 0.4 and 4.0 mg/ml (approximately 10(-6)-10(-2) M) MPA for 72 h. Proteoglycan synthesis was measured by incorporation of sodium [35S]sulfate into proteoglycans and proteoglycan degradation was measured by release of total and radiolabeled proteoglycan into the culture media. The size of the proteoglycans was assessed with size exclusion chromatography under both associative and dissociative conditions. Total protein synthesis was measured by incorporation of [3H]proline and collagen synthesis by formation of [3H]hydroxyproline. RESULTS: Treatments of 0.0004, 0.004, and 0.04 mg/ml MPA caused a significant (p < 0.05) increase in total protein synthesis compared to the control, and doses of 0.0004 and 0.004 mg/ml MPA tended to increase (p < 0.1) collagen synthesis. In contrast, MPA doses of 0.04 mg/ml or less had no effect on proteoglycan synthesis compared to control. Proteoglycan, total protein, and collagen synthesis were severely depressed with the 0.4 and 4.0 mg/ml MPA treatments. The lowest doses of MPA had minimal effect on proteoglycan degradation, while 0.4 and 4.0 mg/ml MPA decreased degradation of total proteoglycan in a dose dependent fashion. Degradation of newly synthesized proteoglycan in the explants was significantly decreased (p < 0.05) by 4.0 mg/ml MPA. There was positive correlation (r = 0.83, p < 0.05) between the effect of MPA on proteoglycan synthesis and the release of total proteoglycan into the culture media. Chromatography under associative conditions showed that treatment with MPA (0.4 and 0.004 mg/ml) decreased the size and increased the polydispersity of aggrecan and induced synthesis of the small nonaggregating proteoglycans. Aggrecan monomers from cartilage treated with MPA included a population of smaller monomers, which resulted in greater polydispersity than those from control cartilage. CONCLUSION: As well as decreasing synthesis, loss of proteoglycan from MPA treated cartilage in vivo may be partly due to the synthesis of a population of smaller proteoglycans than those extracted from untreated cartilage, and these may not interact with hyaluronan and may not be retained permanently in the matrix. Methylprednisolone acetate may affect posttranslational modification of the core protein with the addition of smaller and possibly fewer glycosaminoglycan chains.

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Effects of stromelysin activity on proteoglycan degradation of canine articular cartilage explants.

We investigated whether stromelysin activity in the medium of canine articular cartilage explants is associated with proteoglycan degradation in these explants. Cartilage explants were treated with recombinant human interleukin 1 alpha (rh-IL-1 alpha), lipopolysaccharide, or canine monocyte-conditioned medium. Proteoglycan synthesis and degradation were measured. Metalloproteinase activity (inhibitable by tissue inhibitor of metalloproteinase 2) in the culture medium was measured by use of fluorimetry with a quenched fluorescent substrate. Western blots of the medium were probed with polyclonal antibodies to human stromelysin, collagenase, and gelatinase. Neither metalloproteinase activity nor proteoglycan degradation were inducible in canine cartilage explants treated with rh-IL-1 alpha. However, proteoglycan synthesis was significantly (P < 0.05) decreased by concentrations of 10 and 100 ng of rh-IL-1 alpha/ml. Metalloproteinase activity in the medium accompanied proteoglycan degradation of cartilage treated with lipopolysaccharide and monocyte-conditioned medium. The metalloproteinase released into the medium was identified as prostromelysin by results of western blotting.

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Chondrocyte-fibrin matrix transplants for resurfacing extensive articular cartilage defects.

Cartilage resurfacing by chondrocyte implantation, with fibrin used as a vehicle, was examined in large (12 mm) full-thickness articular cartilage defects in horses. Articular chondrocytes, isolated from a 9-day-old foal, were mixed with fibrinogen and injected with thrombin, in a 1:1 mixture, into 12 mm circular defects on the lateral trochlea of the distal femur of eight normal horses. The contralateral femoropatellar (knee) joint served as a control in which the defect was left empty. Synovial fluid from the femoropatellar joints was sampled on days 0, 4, 7, 30, 120, and 240 postoperatively. Groups of four horses were killed at 4 or 8 months postoperatively, and the repair tissue was evaluated by gross and histologic examination with use of hematoxylin and eosin and safranin O staining and by autoradiography. Biochemical analyses included quantitation of proteoglycan, total collagen, and type-II collagen in the repair tissue. Grossly, grafted defects had improved filling of the cartilage lesions; histologically, these areas consisted of differentiated chondrocytes in the deep and middle zones. The cellular arrangement in these zones resembled that of hyaline cartilage. The control defects contained poorly attached fibrous tissue throughout. Grafted tissue at 8 months had increased proteoglycan synthesis evident by both safranin O staining and autoradiography. Glycosaminoglycan quantitation by dye-binding assay confirmed a significantly elevated glycosaminoglycan content in grafted defects (58.8 micrograms/mg of dry weight) compared with control defects (27.4 micrograms/mg; p < 0.05). Similarly, the levels of chondroitin sulfate/dermatan sulfate was significantly elevated in the grafted defects, and this was the predominant glycosaminoglycan epitope present. There was a statistically significant (p < 0.05) increase in type-II collagen in the grafted tissue at 8 months (61.2% grafted; 25.1% control). This resurfacing attempt with use of allograft chondrocytes, secured in large full-thickness articular defects with polymerized fibrin, resulted in an improved cartilage surface in comparison with the control defects, a significantly greater aggrecan level, and a significantly higher proportion of type-II collagen.

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Cross-validation of cyanogen bromide-peptide ratios to measure the proportion of type II collagen in pepsin digests of equine articular cartilage, meniscus, and cartilage repair tissue.

Collagen type I and type II were purified from equine flexor tendon and articular cartilage, respectively. Equal amounts of these collagens were cleaved with cyanogen bromide, and 11 mixtures containing increasing proportions of type II collagen were separated in seven identical sodium dodecyl sulfate-polyacrylamide gels. The density of bands was measured in wet gels and the peak areas were used to form six ratios of peptide bands that had polynomial relationships with the known proportions of type I and type II collagen in the mixtures. Calibration curves for determining the proportion of type II collagen in the mixtures were constructed using ratios and combinations of ratios of peak areas. Cross-validation was used to identify calibration curves with the smallest squared prediction error or squared average prediction error for all combinations of ratios. Ratios of peak areas of each one of the seven gels were treated, in turn, as the "unknown," and a prediction was carried out using these unknowns and the ratios from the other six gels. Two ratios had the smallest squared average prediction error and calibration curves were computed for these ratios with all seven gels. These curves were used to estimate the proportion of type II collagen in the pepsin-soluble and the pepsin-resistant fractions of articular cartilage inner and outer meniscus, and cartilage repair tissue. Cross-validation enabled selection of the cyanogen bromide-peptide ratios for calibration curves that resulted in the most accurate estimation of the proportion of type II collagen in pepsin digests of tissues.

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Structure of equine type I and type II collagens.

Collagen type I was purified from equine skin and flexor tendon, and type II collagen was purified from equine articular cartilage. The proteoglycans in these tissues were extracted, using guanidine HCl; the collagens were solubilized, using pepsin digestion, then were selectively precipitated with NaCl. Gel electrophoresis indicated that the precipitates contained only type I or type II collagen. Amino acid analysis indicated that collagen constituted > 97% of the total protein in the precipitates. Hydroxylation of proline was 42.0 +/- 0.6% (mean +/- SEM) in alpha 1(I) and alpha 2(I), and was 48.1 +/- 1.3% in alpha 1(II) chains. The hydroxylation of lysine was 23.2 +/- 0.7% in alpha 1(I) and 34.1 +/- 0.9% in alpha 2(I) chains from tendon, and 49.6 +/- 4.3% in alpha 1(II) chains from cartilage. The cyanogen bromide (CB)-peptide patterns of chromatographically purified equine alpha 2(I) and alpha 1(II) chains were similar to those published previously for rat, bovine, and human alpha 2 and alpha 1 chains. However, the CB-peptide pattern of the equine alpha 1(I) chain resembled the guinea pig alpha 1(I) chain, which has no methionine between CB7 and CB6. Purified equine alpha 1(I)CB7,6 contained no methionine, methionine sulfoxide, or homoserine lactone. Mass of 42.26 kd was determined by use of mass spectrometry, and N-terminal sequence analysis established that the first 12 amino acids of this CB7,6 were identical to the sequence of human alpha 1(I)CB7.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acids↗

Effects of exercise and polysulfated glycosaminoglycan on repair of articular cartilage defects in the equine carpus.

Our aim was to determine if mild to moderate postoperative exercise and intra-articular polysulfated glycosaminoglycan result in improved repair of large, experimentally induced osteochondral defects in a weight-bearing surface of equine joints. Arthroscopic debridement was used to produce full-thickness defects in a weight-bearing area of the radial carpal bones in 18 ponies. The ponies were randomly assigned to two groups balanced for age: nine animals in the exercise and nine in the no exercise group. Six ponies in each group were medicated weekly for 5 weeks with an intra-articular injection of polysulfated glycosaminoglycan in one middle carpal joint beginning at the time of operation. Walking (twice daily) was begun 6 days postoperatively, and by the twelfth week postoperatively the ponies were trotting for 25 min and walking for 15 min twice daily. At the time of the ponies' death, 17 weeks postoperatively, each defect had an average of 50-75% coverage with repair tissue. Exercised, medicated joints had a significantly smaller area of coverage with repair tissue than exercised, nonmedicated joints. Cartilaginous repair tissue from exercised ponies contained significantly more glycosaminoglycan and type-II collagen (r = 0.53, p < 0.05). The ratio of hydroxylysine to hydroxyproline was significantly lower and the ratio of collagen content to total protein was significantly higher in the repair tissue of medicated joints than in the repair tissue of nonmedicated joints; this is consistent with the presence of less type-II collagen in the repair tissue in medicated joints. We concluded that postoperative exercise was beneficial and that the immediate postoperative use of intra-articular polysulfated glycosaminoglycan was detrimental to the development of cartilaginous repair tissue in large osteochondral defects of equine joints.

Amino Acids↗

Experimental Lyme disease in dogs produces arthritis and persistent infection.

Lyme disease was reproduced in specific pathogen-free beagle dogs by exposure to Borrelia burgdorferi-infected ticks (Ixodes dammini). Seroconversion and disease frequency were higher after exposure to infected adult ticks than to infected nymphs. Young pups developed clinical disease more readily than older dogs. The incubation period lasted 2-5 months. Acute recurrent lameness with fibrinopurulent arthritis was the dominant clinical sign. Dogs recovered but developed persistent mild polyarthritis. B. burgdorferi persisted in recovered dogs for at least 1 year. Isolation of B. burgdorferi and detection by polymerase chain reaction was most successful from skin biopsies at the site of the tick bite. Antibody to B. burgdorferi antigens was first detected by ELISA and Western blots by 4-6 weeks after exposure. High serum levels persisted during 17 months of observation. In contrast to infection from ticks, inoculation of dogs with cultured B. burgdorferi resulted in seroconversion with a shorter duration of antibody persistence and no clinical disease.

Age Factors↗

Effect of intramuscularly administered polysulfated glycosaminoglycan on articular cartilage from equine joints injected with methylprednisolone acetate.

Intra-articularly administered, long-acting corticosteroids are a beneficial treatment for many equine joint disorders because they alleviate inflammation and signs of pain, but they also exert detrimental effects on the biochemical composition and morphologic features of articular cartilage. Chondroprotective drugs have been shown to mitigate some of the deleterious effects of intra-articularly administered corticosteroids on articular cartilage of laboratory animals. Twenty-one ponies were assigned at random to receive 1 of 3 treatments in the right middle carpal joint. Group-1 ponies (n = 8) had methylprednisolone acetate (MPA; 0.2 mg/kg of body weight) and saline solution administered intra-articularly and IM, respectively. Group-2 ponies (n = 9) received MPA (0.2 mg/kg) and polysulfated glycosaminoglycan (GAG; 2 mg/kg). Group-3 ponies (control; n = 4) had saline solution administered intra-articularly and IM. The corticosteroid or saline solution was injected into the right middle carpal joint on day 1. The IM administered polysulfated GAG or saline solution was administered at the same time, then was repeated every 3 days for 20 days. Ponies were euthanatized 21 days after initial injection by overdose of pentobarbital sodium. The cartilage of younger ponies was significantly (P < 0.05) more responsive to the proteoglycan-depleting effects of MPA. Ponies < 10 years old of groups 1 and 2 had significantly (P < 0.05) lower GAG content in the articular cartilage than did control ponies. Systemic treatment with polysulfated GAG did not result in a protective effect against proteoglycan loss from the articular cartilage.(ABSTRACT TRUNCATED AT 250 WORDS)

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Keratan sulfate as a marker of articular cartilage catabolism and joint treatment in ponies.

Keratan sulfate (KS) is a glycosaminoglycan, distribution of which is confined mostly to hyaline cartilage. As such, it is a putative marker of hyaline cartilage catabolism. In experiment 1, a focal osteochondral defect was made arthroscopically in 1 radial carpal bone of 2 ponies, and in 2 other ponies, chymopapain was injected into the radiocarpal joint to induce cartilage catabolism. Sequential and concurrent plasma and synovial fluid concentrations of KS were measured, up to 13 months after induction of cartilage injury, to determine whether changes in KS concentrations reflected cartilage catabolism. In experiment 2, a large, bilateral osteochondral defect was made in the radial carpal bones of 18 ponies, which were subsequently given postoperative exercise and/or injected intra-articularly with 250 mg of polysulfated glycosaminoglycan (PSGAG). Medication was given at surgery, then weekly for 4 weeks. Blood samples were collected and synovial fluid was aspirated before surgery, when medication was given, and at postmortem examination (postoperative week 17). The KS concentration was measured in these fluids to determine whether changes in KS concentration indicated an effect of joint treatment. In experiment 1, the concentration of KS in synovial fluid was highest 1 day after joint injury, and the concentration in plasma peaked 2 days after joint injury. For ponies receiving chymopapain intra-articularly (generalized cartilage catabolism), a fivefold increase over baseline was observed in the concentration of KS in plasma (peak mean, 1.2 micrograms/ml), and a tenfold increase over baseline in synovial fluid (peak mean, 2.0 mg/ml) was observed. On average, these maxima were threefold higher than values in fluids of ponies with osteochondral defects (focal cartilage disease). In experiment 2, nonexercised ponies had lower KS concentration (as a percentage of the preoperative concentration) in synovial fluid than did exercised ponies at all postoperative times, and at postoperative week 17, this effect was significant (P < 0.05). This may be related to decreased turnover of KS in articular cartilage attributable to stall confinement and late increase in turnover related to exercise. Seventeen weeks after surgery, synovial fluid from exercised, medicated ponies had significantly (P < 0.05) higher KS content than did fluid from exercised, nomedicated ponies. This indicated that exercise, when combined with medication, may increase KS release from articular cartilage. Synovial fluid from medicated joints of nonexercised ponies had significantly (P < 0.05) lower KS concentration than did synovial fluid from nonmedicated joints of nonexercised ponies.(ABSTRACT TRUNCATED AT 250 WORDS)

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Use of scintimetry to assess effects of exercise and polysulfated glycosaminoglycan on equine carpal joints with osteochondral defects.

Combined blood pool and delayed images produced by use of 99mTc-methylene diphosphonate (99mTcMDP) were evaluated as an objective measurement of the response of equine joints with osteochondral defects to postoperative exercise and intra-articularly administered polysulfated glycosaminoglycan (PSGAG). Osteochondral defects (approx 2.4 x 0.9 cm) were induced arthroscopically in the dorsodistal radial carpal bones of 18 ponies. These ponies were randomized (while balancing for age [range 2 to 15; median, 5.0; mean, 5.1 years]) to 2 treatment groups. Nine ponies were assigned to be exercised, and 9 were stall-rested. Six ponies in each group were administered PSGAG (250 mg) in 1 joint (medicated) and lactated Ringer's solution (LRS) in the contralateral joint. The 3 remaining ponies in each group were administered LRS in both joints (nonmedicated). Medication was given at surgery, then weekly for 4 weeks. The exercise protocol (begun at postoperative day 6 and conducted twice daily) started with 30 minutes walking (approx 0.7 m/s), and, by postoperative month 3, the ponies were being walked for 15 minutes and trotted (approx 1.6 m/s) for 25 minutes. Simultaneous dorsal images of both carpi were made 2 to 3 minutes after IV administration of 99mTcMDP (blood pool image) and 90 to 120 minutes later (delayed image). Scintimetry, in counts per minute per pixel per millicurie, was done before, and at 1, 2, 4, 8, 10, 13, and 17 weeks after surgery, prior to euthanasia. Radionuclide uptake on blood pool images decreased faster than that on delayed images, in which uptake remained high for 17 weeks. This indicated that bone was metabolically active for at least 17 weeks after surgery. Exercise significantly (P < 0.05) decreased uptake on the blood pool images of medicated joints up to 1 month after surgery. Thus, exercise (in the presence of PSGAG) probably had a transient, beneficial effect on soft tissues of the joint. Exercise, without PSGAG, promoted increased bone remodeling, because the highest uptake on delayed images was observed in exercised, nonmedicated ponies up to 3 months after surgery. This was consistent with development of osteoarthritis in these ponies. Medication alone stimulated bone remodeling, and data indicated that an identical effect may take place in contralateral LRS-injected joints, because of systemic circulation of the drug. However, the combination of exercise and medication appeared to moderate the independent effects of each. The combination of exercise and medication in individual joints resulted in notably (P < 0.05) decreased bone remodeling.(ABSTRACT TRUNCATED AT 400 WORDS)

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Surgical repair of urethral transection in a horse.

A recently castrated horse was examined because of preputial and ventral abdominal swelling, prolapse of the preputial fold, and serosanguinous fluid dripping from the external urethral orifice. After a poor response to initial medical management, a urethral laceration was found during exploratory surgery. Half of the ventral portion of the corpus cavernosum penis had been transected. Primary closure was followed by healing without complications.

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Attempts to prevent equine post neurectomy neuroma formation through retrograde transport of two neurotoxins, doxorubicin and ricin.

Digital neurectomies, performed to relieve pain and lameness, are often complicated postoperatively by formation of painful neuromas. In this study attempts were made to deliver lethal doses of neurotoxin to the cell bodies of the transected digital nerve fibres via long-distance retrograde axon transport and, thereby, prevent the regenerative changes that lead to neuroma formation. After applying doxorubicin in various ways to the digital nerve stumps of ponies, degenerating or necrotic neurones appeared only sporadically in the spinal ganglia. Although doxorubicin was largely ineffective in retrograde destruction of cell bodies, when absorbed in pledgets on the stumps it exerted a sustained action which prevented Schwann cell proliferation and axon sprouting. Ricin, in contrast to doxorubicin, was effective in retrograde destruction of sensory neurons. Many affected neurons were devoid of polysomes but packed with mitochondria; others had advanced to various stages in cytolysis. Despite its effectiveness, ricin cannot be recommended because of its extreme toxicity. The clinical use of retrograde transport in equine neurectomy will probably depend on future development of hybrid toxins with high neural specificity and low systemic toxicity.

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Herniation of the abdominal wall in pregnant mares.

Abdominal wall hernia was detected in 4 pregnant mares. Antemortem diagnosis of the specific abdominal wall lesion was difficult. Ventral deviation of the abdomen, associated abdominal wall edema, and pain indicated rupture of the prepubic tendon. Three mares examined at necropsy did not have a rupture of the prepubic tendon but did have herniation of the abdominal wall. Abdominal pain was severe and was compounded by incarceration or entrapment of viscus.

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Gastric rupture in horses: a review of 54 cases.

The historical, clinical, laboratory, surgical and necropsy findings in 54 cases of gastric rupture in horses are described. Eleven per cent of the deaths of horses undergoing exploratory coeliotomy for colic during the period of the study were a result of gastric rupture. Comparison with all horses which had exploratory coeliotomies for colic over an eight year period did not show that horses with gastric rupture were different from these reference horses regarding age, breed or season. There were fewer stallions than expected in the gastric rupture group. Horses with histories of both acute and chronic (more than 36 h) colic were susceptible to gastric rupture. Primary and idiopathic causes of gastric dilation and rupture accounted for about one-third of the horses. All but one of these cases resulting from secondary causes fell into three aetiologically-related groups: obstructive, peritoneal and enteric, with approximately equal numbers of horses in each group. Most of the ruptures occurred along the greater curvature of the stomach. At least six horses ruptured their stomachs postoperatively in the presence of an indwelling nasogastric tube. The presence or absence of gastric reflux following nasogastric intubation was not a reliable indicator, on its own, of gastric dilation. Horses that later died from gastric rupture had markedly elevated heart rate, hypochloraemia, peritoneal exudative effusion (particularly with evidence of sepsis), pre- and/or postoperative gastric reflux and small or large intestinal disease. However, no distinctive feature of these horses was shown to place them at risk of gastric rupture.

Age Factors↗

Comparison of three feeding techniques after esophageal mucosal resection and anastomosis in the horse.

The effects of 3 feeding techniques on healing of a cervical esophageal mucosal resection and anastomosis were investigated in 16 horses. Horses were fed a moistened pelleted diet 1 of 3 ways: 1) per os (n = 5), 2) by nasogastric (n = 5) or 3) by esophagostomy tube (n = 6) until the 14th postoperative day. The pelleted diet was then fed orally in all horses until euthanasia on the 60th postoperative day. Immediate postoperative feeding per os was unsatisfactory, as only 2 of 5 horses survived in this group. Endoscopic evaluation revealed that mucosal dehiscence of varying degrees occurred, with subsequent stricture formation in all horses. Although the incidence of some complications (fistula, sinus tract and traction diverticulum) was higher in the nasogastric tube-fed horses, 2 of 6 horses in the esophagostomy tube-fed group did not survive to the end of the study. There was more cervical phlegmon in the esophagostomy tube-fed group, and this resulted in increased periesophageal fibrosis on histopathologic examination. Radiographic measurements showed that esophageal lumen diameter increased predominantly between 30 and 45 days postoperatively. The mucosal healing time was significantly faster (p = 0.05) in the esophagostomy tube-fed group.

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